The Alberta government is making very important strides in implementing Supervised Consumption Service, (SCS), regulations in that province. (Calgary Herald) As a person with lived-experience and a Community Peer Support worker I can say with great confidence and expertise that the regulation of SCS is an absolute must supporting not only the clients who use such services but also the accountability and transparency of health care agencies providing such services.
It is very disappointing to also learn that harm reduction advocates who claim concern about the health of SCS clients are legally contesting Alberta’s adoption of such regulations. The issue is related to the introduction of the practice of collecting SCS clients’ Personal Health Number, (PHN), although, no person shall be barred from using the service without this information. It is purported by these advocates that such identification collection will drive away SCS clients and subject them to greater risk of overdose. This position fails to recognize the importance of using such identification to better track clients and provide a system for evaluation greatly improving the continuum of care and patient flow as well as supporting the demand for evidence-based solutions which cannot be met without client data.
This is a necessary high priority criteria for a health care system that will provide many benefits including best practices, transparency, and enables the development of improvements through external review and accreditation. (Quality of Health Care) Given the significant mortalities and growing drug crises in Canada, a continuum of care allows the identification of high risk clients which can only happen when the delivery of services can be identified, vis-a-vis, the PHN of the client. As a result of being able to identify high risk clients and risk factors, a prevention solution can be considered while also allowing for recognition of others that may also be at risk. Use of SCS as an anonymous client does not allow for the investigation of fatal overdoses occurring on or away from the site thereby providing no feedback, therefore no improvements or addressing client risk factors can take place.
Currently, consumption site services do not complete an investigation when a client fatally injects as the use of the services is anonymous and thus introduces an issue related to transparency and no ability to introduce practices reducing this risk. (Fatal Overdose and Use of Naloxone) Additionally, the Alberta Health Services coroner’s reports only the number of visits and syringes distributed, and naloxone kits given out. To develop a more robust continuum of care, it is necessary to know more, for example, what contact the client had before fatal or non-fatal overdose. This knowledge leads to a system that can be developed and interventions determined.
